Individual provider Active NPI

Leah Holbrook

  • Physical Therapist
  • Portland, OR
National Provider Identifier
1952787335
Registry record updated Sep 18, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
62966 Issued in OR
Practice address
10215 SW Park Way Ste D
Portland, OR 97225
Phone
(503) 292-3583
Fax
(503) 292-1022
NPI assigned
Aug 7, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT30621 FL
Physical Therapist 225100000X 62966 OR Primary

Addresses

Primary practice location

10215 SW Park Way Ste D
Portland, OR 97225

Mailing address

16083 SW Upper Boones Ferry Rd Ste 300
Tigard, OR 97224-7736
Phone (503) 443-6156

Other practice location 1

4501 Vineland Rd
Suite 103
Orlando, FL 32811-7375
Phone (407) 426-7066

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR, WA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20181114003658 OR Practitioner - Physical Therapist in Private Practice 4789938424 Reassigns benefits to 1 organization
I20200408003273 WA Practitioner - Physical Therapist in Private Practice 4789938424 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Therapeutic Associates IncGroup PAC ID 0042116279, shared by 5 NPIs, 319 clinicians

Practice addresses (Care Compare)

10215 SW Pkwy
Suite D
Portland, OR 97225-5036
Phone (503) 292-3583

19400 108TH Ave SE
Suite 100
Kent, WA 98031-0108
Phone (425) 272-0252

5420 Barnes Ave NW
Seattle, WA 98107-3839
Phone (206) 789-7975

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT30621FLMDPhysical Therapist
62966ORMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Therapeutic Associates Inc Physical Therapist CurrentSince Aug 22, 2018 Accepting new patients
Therapeutic Associates Inc Physical Therapist Current Accepting new patients
Therapeutic Associates Inc Physical Therapist CurrentSince Dec 5, 2019 Accepting new patients
Therapeutic Associates Inc Physical Therapist CurrentSince Aug 22, 2018 Accepting new patients
Therapeutic Associates Inc Physical Therapist Current Accepting new patients
Therapeutic Associates Inc Physical Therapist Past Accepting new patients
Therapeutic Associates Inc Physical Therapist Past Accepting new patients
Therapeutic Associates Inc Physical Therapist Past Accepting new patients

Locations

16315 SW Barrows Rd
Ste 205
Beaverton, OR 97007
Phone (503) 521-0500

8028 NE Glisan St
Ste B
Portland, OR 97213
Phone (503) 253-0924

10215 SW Parkway
Ste D
Portland, OR 97225
Phone (503) 292-3583

58147 Columbia River Hwy
Ste A
Saint Helens, OR 97051
Phone (503) 397-1914

20055 SW Pacific Hwy
Ste 110
Sherwood, OR 97140
Phone (503) 625-1691

16083 SW Upper Boones Ferry Rd
Ste 300
Tigard, OR 97224
Phone (503) 443-6153

29100 SW Town Center Loop W
Ste 190
Wilsonville, OR 97070
Phone (503) 570-7600

5420 Barnes Ave NW
Seattle, WA 98107
Phone (206) 789-7975

509 Olive Way
Ste 1011
Seattle, WA 98101
Phone (206) 623-4570

2611 NE 125th St
Ste 140
Seattle, WA 98125
Phone (206) 361-4745

Interoperability endpoints

  • Direct secure messaging: leah.holbrook.1@31414.direct.athenahealth.com

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1438905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537228800000",
    "number": "1952787335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16083 SW UPPER BOONES FERRY RD STE 300",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972247736",
            "telephone_number": "503-443-6156",
            "fax_number": "503-639-9699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10215 SW PARK WAY STE D",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97225",
            "telephone_number": "503-292-3583",
            "fax_number": "503-292-1022"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4501 Vineland Rd",
            "address_2": "Suite 103",
            "address_purpose": "LOCATION",
            "city": "Orlando",
            "state": "FL",
            "postal_code": "328117375",
            "country_code": "US",
            "telephone_number": "407-426-7066",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOLBROOK",
        "first_name": "LEAH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-07",
        "last_updated": "2018-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT30621",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "62966",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.